Day: September 8, 2022

Categories : VaccinesTags :

Oxford’s New Malaria Vaccine is ‘World Changing’

On By ModernMedia
Mosquito, a malaria parasite vector
Photo by Егор Камелев on Unsplash

A malaria vaccine developed by Oxford University has been described as “world changing” following its successful trial in children in Burkina Faso. Their results of their double-blind randomised controlled trial were published yesterday in The Lancet Infectious Diseases.

The researchers had previously reported that in children, the R21/Matrix-M malaria vaccine reached the WHO-specified goal of 75% or greater efficacy over 12 months.

To test the immunogenicity, and efficacy results at 12 months after administration of a booster vaccination, the researchers conducted a trial was done in children aged 5–17 months in Burkina Faso, who had written informed consent provided by their caregivers. Eligible children were randomised to receive three vaccinations of either 5 μg R21/25 μg Matrix-M, 5 μg R21/50 μg Matrix-M, or a control vaccine (the Rabivax-S rabies vaccine) before the malaria season, with a booster dose 12 months later. Exclusion criteria included any existing clinically significant comorbidity or receipt of other investigational products.

Vaccine safety, efficacy, and a potential correlate of efficacy with immunogenicity, measured as anti-NANP antibody titres, were evaluated over one year following the first booster vaccination. Efficacy analyses were performed for all participants who received the primary series of vaccinations and a booster vaccination.

Between June 2, and July 2, 2020, 409 children returned to receive a booster vaccine, which was the same received in the primary series of vaccinations. R21/Matrix-M had a favourable safety profile and was well tolerated. Vaccine efficacy remained high in the high adjuvant dose (50 μg) group, similar to previous findings at one year after the primary series of vaccinations. Following the booster vaccination, 51% of children receiving R21/Matrix-M with low-dose adjuvant, 39% of children receiving the same but with high-dose adjuvant, and 86% of 140 children who received the rabies vaccine developed clinical malaria by 12 months.

Vaccine efficacy was 71% in the low-dose adjuvant group and 80% in the high-dose adjuvant group. In the high-dose adjuvant group, vaccine efficacy against multiple episodes of malaria was 78%, and 2285 cases of malaria were averted per 1000 child-years at risk among vaccinated children in the second year of follow-up. Among these participants, at 28 days following their last R21/Matrix-M vaccination, titres of malaria-specific anti-NANP antibodies correlated positively with protection against malaria in both the first year of follow-up (Spearman’s ρ –0·32 [95% CI –0·45 to –0·19]; p = 0·0001) and second year of follow-up (–0·20 [–0·34 to –0·06]; p = 0·02).

A booster dose of R21/Matrix-M at 1 year following the primary three-dose regimen maintained high efficacy against first and multiple episodes of clinical malaria. Furthermore, the booster vaccine induced antibody concentrations that correlated with vaccine efficacy. The trial is ongoing to assess long-term follow-up of these participants and the value of further booster vaccinations.

Speaking to BBC News, Prof Katie Ewer said that “this is not like COVID where we have seven vaccines straight away that will work… it’s much, much harder”. This malaria vaccine is the 14th that she has worked on, and it was “incredibly gratifying” to get this far and “the potential achievement that this vaccine could have if it’s rolled out could be really world-changing”.

The Oxford-developed vaccine shares similarities with the current, approved malaria vaccine from GSK: both target the first stage of the parasite’s lifecycle by intercepting it before it can establish itself in the liver.

The vaccines use a combination of proteins from the malaria parasite and the hepatitis B virus, but the Oxford vaccines has a more malaria proteins, which may help the immune system to focus on malaria rather than the hepatitis.

The trial is continuing for a further 2 years to assess both the potential value of additional booster vaccine doses and longer-term safety.

Categories : Ageing Injury & TraumaTags :

A Biomarker for Male Hip Fracture Risk

On By ModernMedia
Photo by Mehmet Turgut Kirkgoz on Unsplash

In new research published in the Journal of Bone and Mineral Research, elevated blood levels of a certain chemokine, or small signalling protein, that promotes osteoclast formation were linked with a higher risk of hip fracture in men.

To maintain bone health, a balanced activity of various bone cell types including bone-forming osteoblasts and bone-resorbing osteoclasts has to take place. When osteoclasts dominate without adequate bone formation to compensate, osteoporosis results.

The study included 55 men and 119 women who had experienced a hip fracture an average of 6.3 years after their blood was collected. The participants were matched individually to controls who did not develop hip fractures.

The researchers found higher levels of the chemokine CXCL9 in the pre-fracture blood samples of men with subsequent hip fractures compared with their non-fracture controls. In women, the researchers saw no such.

“The unexpected difference in the results between men and women in our study may be explained by how changes in sex hormone levels during aging could influence the level and effects of CXCL9 differently in older men and women,” explained corresponding author Woon-Puay Koh, MBBS, PhD, from the National University of Singapore (NUS).

“Our findings open the exciting possibility that early interventions targeting CXCL9 or CXCL9-CXCR3 signalling could be beneficial in preventing hip fractures in older men,” added co-corresponding author Christoph Winkler, PhD, also from NUS.

Source: Wiley

Categories : ExerciseTags :

Lasting Benefits from Swapping 30 Minutes of Social Media for Exercise

On By ModernMedia
Photo by Freestocks on Unsplash

In a study in the Journal of Public Health, participants who exchanged 30 minutes of social media use per day for exercise felt happier, more satisfied, less stressed by the COVID pandemic and less depressed than a control group. These effects persisted even six months after the study had ended.

The downside of social media

While it helped people stay connected during the COVID pandemic, social media consumption has also its drawbacks. Heavy use can lead to addictive behaviour that manifests itself in, for example, a close emotional bond to the social media. In addition, fake news and conspiracy theories can spread uncontrollably on social channels and trigger even more anxiety.

“Given that we don’t know for certain how long the coronavirus crisis will last, we wanted to know how to protect people’s mental health with services that are as free and low-threshold as possible,” explained assistant professor Dr. Julia Brailovskaia, who lead a team from the Mental Health Research and Treatment Center at Ruhr-Universität Bochum. To find out whether the type and duration of social media use can contribute to this, she and her team conducted an experimental study, with a total of 642 participants randomised to one of four groups.

A two-week experiment

The first group reduced the daily social media consumption by 30 minutes during an intervention period of two weeks. Since previous studies had shown that physical activity can increase well-being and reduce depressive symptoms, the second group increased the duration of physical activity by 30 minutes daily during this period, while continuing to use social media as usual. The third group combined both, reducing social media use and increasing physical activity. A control group didn’t change the behaviour during the intervention phase.

Before, during and up to six months after the two-week intervention phase, the participants responded to online surveys on the duration, intensity and emotional significance of their social media use, physical activity, their satisfaction with life, their subjective feeling of happiness, depressive symptoms, the psychological burden of the COVID pandemic and their cigarette consumption.

Healthy and happy in the age of digitalisation

The findings clearly showed that both reducing the amount of time spent on social media each day and increasing physical activity have a positive impact on people’s well-being. The combination of the two interventions in particular increases one’s satisfaction with life and subjective feeling of happiness and reduces depressive symptoms. Even six months after the two-week intervention phase had ended, participants in all three intervention groups spent less time on social media than before: about a half hour in the groups that had either reduced social media time or increased their daily exercise, and about three-quarters of an hour in the group that had combined both measures. Six months after the intervention, the combination group engaged one hour and 39 minutes more each week in physical activity than before the experiment. The positive influence on mental health continued throughout the entire follow-up period.

“This shows us how vital it is to reduce our availability online from time to time and to go back to our human roots,” Julia Brailovskaia concluded. “These measures can be easily implemented into one’s everyday life and they’re completely free — and, at the same time, they help us to stay happy and healthy in the digital age.”

Source: Ruhr-University Bochum

Categories : Ethics and Law HospitalsTags :

Health MEC Liable for Patient Who Fell to His Death, Court Rules

On By ModernMedia
Photo by Tingey Injury Law Firm on Unsplash

By Tania Broughton for GroundUp

The High Court in Gqeberha has found that the Eastern Cape MEC for Health and Livingstone Hospital are liable to pay damages to the widow of a man who died after falling from the fifth floor of the hospital.

In the ruling last week, Acting Judge Ivana Bands found that the patient, George Williams, had not been properly medicated or monitored. She said that had this been done, Williams would not have been “pacing up and down the ward, in confused, restless and disoriented state”, and would not have fallen to his death from the window.

Judge Bands said the conduct of the medical and nursing personnel who treated Williams after he was admitted to the hospital on 3 October 2013, “fell far short of what is regarded as sound practice” in dealing with patients suffering from alcohol withdrawal – delirium tremens which involves sudden and severe mental or nervous system changes – and secondary schizophrenia.

“Had he been properly medicated, it cannot be gainsaid [denied] that he would have been reduced to a calm and lightly dozing state. This would have enabled the medical and nursing staff to monitor his vital signs and his condition appropriately until such time that delirium tremens had abated,” Judge Bands said.

Read the judgment

Judge Bands’s finding of negligence means that Williams’s widow Jeanine can now pursue a monetary damages claim against the MEC and hospital. This could be determined at another trial or through negotiation.

Jeanine Williams, in her papers, contended that the hospital staff were under a legal duty to provide her husband with adequate and timeous medical treatment; that they had not properly sedated him, restricted his movements and monitored his condition.

The defendants, however, argued that Williams had been treated with sedatives, including diazepam (Valium) and that he had been put in an “enclosed locked ward” close to the nurses’ station.

Bands said Wiliams was a known alcoholic who was admitted to the hospital late on 3 October 2013. In the early hours of the morning, he had been given diazepam, with little effect. During the evening of 4 October, he was given more sedatives and an antipsychotic agent, also with no effect.

Soon after, at about 10:30pm, Williams broke the outside entrance glass door of the nurses’ tearoom and fell from the fifth floor. He died about an hour later.

Two key witnesses during the trial were Dr Candice Harris, a professional nurse and general practitioner, who testified for Williams, and Dr Michelle Walsh, a general surgeon, who testified for the MEC and the hospital.

In her evidence, Harris had said delirium tremens was a “medical emergency” and, according to guidelines, immediate management of the condition was necessary. She had stressed the importance of re-orientating the patient and said it was the nurse’s duty to inform the doctor if the patient was not responding to medication.

The judge said Walsh’s evidence was that it was not that the hospital was doing nothing – “they were doing something”.

“She said the sedation prescribed is usually based on what the assessing doctor thinks will have the desired effect to calm the patient to the extent that they would sit calmly in a chair. It is common cause that this desired state was never reached,” the judge said.

“Not only was he under-sedated, there is no evidence that the initial dose, which had no effect, was ever increased as per the published guidelines, in spite of multiple entries in the hospital records that he remained confused, disorientated, restless and walking up and down – and that he had become so agitated that the nursing staff feared he would assault them,” the judge said.

Bands said Williams had not been treated according to the guidelines, thus the MEC and the hospital are liable for any proven damages.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Injury & TraumaTags :

Repeated Concussions can Result in Skull Thickening

On By ModernMedia
MRI images of the brain
Photo by Anna Shvets on Pexels

Published in the journal Scientific Reports, a study led by Associate Professor Bridgette Semple from Monash University, found that repeated concussions resulted in thicker, denser bones in the skull.

Although bones are considered a mostly structural component of the human body, bones are in fact active living tissues that can respond to applied mechanical forces. For example, martial arts training, with its kicks, punches and throws, has been shown to increase bone mineral density in the arms, legs and spines of practitioners.

At present, it is unclear whether this thickening of the skull is beneficial or detrimental: theoretically, a thicker skull is a stronger skull, suggesting that this may be the bone’s attempt to protect the brain from subsequent impacts.

“This is a bit of a conundrum,” Assoc Prof Semple said. “As we know, repeated concussions can have negative consequences for brain structure and function. Regardless, concussion is never a good thing.”

The team hopes that the microstructural skull alterations caused by concussion are now considered by researchers in the field to better understand how concussions affect the whole body.

A form of mild traumatic brain injury, concussion have been linked to long-term neurological consequences if they happen repetition.

While most studies focus on its effect on the brain and its function, they largely ignore the overlying skull bones.

Study collaborator Professor Melinda Fitzgerald, from Curtin University and the Perron Institute in Western Australia, has previously shown that repeated concussive impacts lead to subtle problems with memory, and evidence of brain damage.

In this new study, high-resolution neuroimaging and tissue staining techniques were used in a pre-clinical animal model, and revealed an increase in bone thickness and density, in close proximity to the site of injury.

“We have been ignoring the potential influence of the skull in how concussive impacts can affect the brain,” Associate Professor Semple said. “These new findings highlight that the skull may be an important factor that affects the consequences of repeated concussions for individuals.”

Future studies are planned, with collaborator and bone expert Professor Natalie Sims from St Vincent’s Institute of Medical Research in Melbourne, to understand if a thickened skull resulting from repeated concussions alters the transmission of impact force through the skull and into the vulnerable brain tissue underneath.

Source: Monash University